Lesson 6.2 : IV Cannulation

Lesson 6.2: IV Cannulation

Cannulation is tested regularly. Examiners specifically assess sharps safety, aseptic technique, and communication throughout. Getting the size of cannula right is part of the clinical assessment.

Cannula Size Selection

Step-by-Step

1. Introduce, confirm identity, explain: 'I need to insert a small plastic tube into a vein in your arm so we can give you fluids or medications quickly if needed.'
2. Consent. Ask about previous difficult access.
3. Equipment: appropriate cannula, sterile dressing, 10 mL flush (0.9% NaCl), Luer lock cap, tourniquet, alcohol wipe, gauze, sharps bin, gloves.
4. Wash hands. Apply non-sterile gloves.
5. Apply tourniquet. Identify vein — dorsum of hand, antecubital fossa, or forearm. Clean skin. Allow to dry.
6. Stretch the skin distally to stabilise the vein. Warn the patient.
7. Insert cannula bevel up at 10–25 degrees. Watch for flashback in the chamber.
8. Advance the cannula 2 mm further once flashback appears, then advance the plastic cannula while withdrawing the needle simultaneously.
9. Release tourniquet. Occlude the vein proximally with your finger. Remove needle completely.
10. Attach Luer lock cap immediately. Activate safety device. Dispose into sharps bin.
11. Flush with 10 mL 0.9% NaCl — check for resistance, swelling (tissuing), or pain.
12. Apply sterile dressing. Write date, time, and initials on the dressing. Thank the patient.
13. Document: site, gauge, date and time, any complications, who inserted.

If the Cannula Tissues (Infiltrates)